ObjectiveThe aim of this study was to assess the spatial distribution and determinant factors of anaemia among reproductive age women in Ethiopia.MethodsAn in-depth analysis of the 2016 Ethiopian Demographic and Health Survey data was undertaken. Getis-Ord Gi* statistics were used to identify the hot and cold spot areas for anaemia among women of reproductive age. A multilevel logistic regression model was used to identify independent predictors of anaemia among women of reproductive age.ResultsOlder age (adjusted OR [AOR]=0.75; 95% CI 0.64 to 0.96), no education (AOR=1.37; 95% CI 1.102 to 1.72), lowest wealth quantile (AOR=1.29; 95% CI 1.014 to 1.60), currently pregnant (AOR=1.28; 95% CI 1.10 to 1.51, currently breast feeding (AOR=1.09; 95% CI 1.025 to 1.28), high gravidity (AOR=1.39; 95% CI 1.13 to 1.69) and HIV positive (AOR=2.11; 95% CI 1.59 to 2.79) are individual factors associated with the occurrence of anaemia. Likewise, living in a rural area (AOR=1.29; 95% CI 1.02 to 1.63) and availability of unimproved latrine facilities (AOR=1.18; 95% CI 1.01 to 1.39) are community-level factors associated with higher odds of anaemia. The spatial analysis indicated that statistically high hotspots of anaemia were observed in the eastern (Somali, Dire Dawa and Harari regions) and north-eastern (Afar) parts of the country.ConclusionThe prevalence rate of anaemia among women of reproductive age varied across the country. Significant hotspots/high prevalence of anaemia was observed in the eastern and north-eastern parts of Ethiopia. Anaemia prevention strategies need to be targeted on rural residents, women with limited to no education, women who are breast feeding, areas with poor latrine facilities and women who are HIV positive.

Background Women with prior gestational diabetes (GDM) have an increased lifetime risk of developing type 2 diabetes mellitus (T2DM). There are no up-to-date systematic reviews analyzing the relationship of diet with risk of developing T2DM following GDM.Objective To systematically review the evidence from intervention and observational studies on effects of dietary interventions and associations of dietary intake with T2DM outcomes in women with a GDM history.Methods Six electronic databases were searched (Cumulative Index to Nursing and Allied Health Literature, Embase, Medline, Cochrane Central, Proquest, and Scopus) for articles published until May 2019. This review includes intervention and observational studies among women of any age with a history of GDM that reported on the effects of dietary interventions or association of dietary intake (energy, nutrients, foods, dietary patterns) with T2DM, impaired glucose tolerance, impaired fasting glucose, or prediabetes. ResultsThe systematic review identified five articles reporting results from four intervention studies, and seven articles reporting results from four observational studies. Findings from intervention studies indicated trends toward beneficial effects of a low-glycemic index diet, a low-carbohydrate diet, and a diet in line with general population dietary guidelines, but studies had unclear or high risk of bias. Findings from two cross-sectional and one prospective study indicated poorer diabetes outcomes for women with higher intakes of branched-chain amino acids, total and heme iron, and a diet relatively low in carbohydrates and high in animal fat and protein, and better outcomes among those consuming diets rich in fruit, vegetables, nuts, fish, and legumes, and low in red and processed meats and sugar-sweetened beverages, after adjustment for confounders, including body mass index.Conclusions Findings from observational studies support current dietary guidelines for the prevention of T2DM. Further dietary intervention studies are needed to confirm whether or not dietary modification following a GDM pregnancy reduces women's risk of developing T2DM.

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